Practical treatise on the diseases of the uterus, ovaries and fallopian tubes / by A. Courty ; translated from the third edition ... by Agnes M'Laren ; with preface by J. Matthews Duncan.

Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Practical treatise on the diseases of the uterus, ovaries and fallopian tubes / by A. Courty ; translated from the third edition ... by Agnes M'Laren ; with preface by J. Matthews Duncan. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    813/842 (page 801)
    the alterations which the most apparent sexual phenomenon, menstrua- tion, may undergo. We should therefore, first of all, ask a sterile woman whether this function is absent, anomalous, or regular. Absence of menstruation may depend on congenital absence, atrophy, arrest of development, or imperfection of some portions of the sexual economy, or on accidental lesions, suppuration, gangrene, adhesions, or obliterations of the same parts. The prognosis is almost always serious as regards the fertility of the woman; except in slight uterine atrophy there is hardly anything to hope from treatment. Absence of menstruation may be associated, although rarely, with normal con- formation of the genital organs, merely constituting a physiological anomaly or imperfection, as is proved by the fact that women who have never menstruated have had children. Eondelet and Joubert1 have both published cases; the former of a woman, who had twelve children, the latter of one who had eighteen, neither of whom had ever menstruated; Colombat2 knew another who had a child; Tlechner3 speaks of a woman in similar conditions having had six pregnancies in thirteen years; Barbieri,4 Bruck5 and Elsasser have each seen a case of the same kind. Stark’s6 work on this subject should be consulted. It must however, be admitted that the physiological absence of menstruation is usually accompanied by sterility, and it is not certain whether it does not sometimes depend on a serious disorder, not only of the function but of the sexual economy. Therefore when consulted about a case of this kind, we cannot be too careful in giving an opinion, which cannot be based on a complete examination of organs inaccessible to our investigations. Anomalies of menstruation are produced either by mechanical causes or morbid states. The former are manifested under the form of menstrual retention, deviated menstruation, dysmenorrhcea, &c.; the physician should discover the congenital or acquired origin and the superficial or internal seat of the obstacle to the free discharge of blood. The latter include amenorrhcea, leucorrhcea, dysmenorrhea, menorrhagia, &c.; it is important to know whether they depend on a merely local or a general condition, whether there is disease of the uterine mucous membrane, deviation or flexion of the womb, active or passive congestion, &c.; or whether the patient is suf- fering from chlorosis, ansemia, plethora, organic disorders, scrofula, constitutional syphilis, or any other diathesis. As these maladies do not always produce menstrual disorders, they ought to receive great attention when they do so and they then indicate the neces- sity for the association of general with local treatment. There is one which is all the more deserving of attention because apparently it does not prevent conception. 1 mean menorrhagia or metrorrhagia; 1 Erreufs popidaires, liv. ii, ch. 1. 2 Op. cit., p. 34. 3 Gaz. med., 1841, p, 91. 4 Gaz. med., 1843, p. 207. 5 Allgem. medic, central. Zeitung, 1854, No. 14. 8 Dee grossesses survenues en l'absence de la menstruation, Stark’s Archiv fur die Geburtshiilfe. Jena, 1787. 6]